I am unapologetically indoorsy,” writes the science journalist Emily Anthes in her new book, The Great Indoors. “Lots of journalists file dispatches from far-flung places—reporting on wildlife in the Serengeti, floods in the Mekong Delta, and ice cores in Antarctica—but I’ve always felt most comfortable plying my craft from deep inside my living room.”
As the era of COVID-19 self-isolation wears on, those of us lucky enough to be employed and able to work remotely have spent months plying our craft from the sofa or the basement. But being stuck inside doesn’t mean being nowhere. Indoor spaces can be just as consequential as outdoor ones, whether a cozy bedroom nook or a swirling marble staircase. The Great Indoors is a rollicking exploration of how everything from lighting to ventilation, noise levels to stairwells, shapes our physical health and mental well-being.
The book’s central premise is that the great indoors deserves as much scientific and sociological investigation as the wilderness. “The indoor environment shapes our lives in far-reaching and sometimes surprising ways,” Anthes writes. We may daydream about mountains and oceans, but most of us, at least in the developed world, spend the bulk of our time under a low ceiling. “Modern humans are essentially an indoor species,” she says, pointing to research that North Americans and Europeans spent nine-tenths of their lives indoors even before the current pandemic. The global tide of urbanization will only accelerate this indoors-ification. The United Nations estimates that over the next 40 years, indoor square footage—enclosed spaces of homes, offices, airports, stores, and more—will nearly double.
The science of buildings, especially life inside them, is not a discrete specialty, so Anthes takes a broad approach to her inquiry. She interviews microbiologists studying bacteria in bathrooms, neuroscientists looking at how our brains respond to lighting changes, and anthropologists investigating how architecture shapes personal interactions. The book is not marshaling evidence to make a narrow argument but, rather, inviting readers to find unexpected significance in the familiar spaces of our homes, hospitals, and workplaces.
One point of consensus: Open offices were a terrible idea, even before COVID-19 arrived. They don’t facilitate productive brainstorming, and no one does their best work surrounded by germs and background chatter. In fact, a 2011 study in Denmark found that people toiling in open offices took 62 percent more sick days than people who worked in private offices. Cramming people into crowded indoor spaces also raises levels of carbon dioxide “high enough to make us drowsy and muddle our thinking,” thanks to our own breathing.
Anthes sifts through piles of scientific research to dig out such tidbits, which tend to be surprising in their mathematical precision and yet often confirm our intuition. A 2016 study in Canada looked at medical records for nearly 8,000 adults who’d suffered cardiac arrests, some of them living in high-rise apartments. Patients living on a first or second floor survived 4.2 percent of the time; those living above the 16th floor, just 1 percent of the time. “The higher up people were when they collapsed, the longer it took paramedics to reach them and the lower their odds of survival,” Anthes concludes. It’s fair to wonder, however, whether there’s another explanation for patient survival rates. Curious sleuths can check the exhaustive notes at the end of the book to reference the original studies (this one is from the Canadian Medical Association Journal), but in general, the reader must trust Anthes, a respected writer whose previous book, Frankenstein’s Cat, won several science journalism prizes.
The first imperative of most indoor environments, almost by definition, is to shield its occupants from what’s outside. (Partial exceptions include greenhouses and tanning salons.) A roof that lets in the rain, or a tent that lets in the bugs, isn’t doing its job. A key theme of Anthes’s book, however, is the degree to which the inverse phenomenon is also true: Dwellings that remove us too far from the natural world can be just as harmful as ones that don’t protect us enough.
Take sunlight. Patients in hospital rooms without windows use more painkillers, report more stress, are discharged later, and have higher mortality rates than those in sunny rooms, according to several studies. “Though it’s difficult to pinpoint the precise mechanism, sunlight can reduce blood pressure, enhance mood, boost vitamin D production, and, we now know, kill pathogens,” Anthes writes. Natural light variation during the day is also significant. Scientists believe the short-wavelength light of morning, which looks cool and bluish to us, is most vital for controlling our circadian rhythms, regulating daily changes in respiration, blood pressure, hormone levels, and immune activity. Some hospitals are now experimenting with artificial indoor “circadian lighting” that varies throughout the day, from morning blues to golden afternoons.
Greenery is also important. A pioneering study published in Science magazine in 1984 compared the medical records of patients who had their gallbladders removed at a Pennsylvania hospital between 1972 and 1981. Half had window views of a forest; half stared through windows at adjacent building walls. The former group requested fewer painkillers and were discharged from the hospital a day sooner. Many subsequent studies have linked time spent outdoors or in plant-filled rooms to higher test scores and better overall health—although, unlike the gallbladder study, these tests generally can’t rule out the potential impact of other factors. (Perhaps wealthy people, for example, who have better health outcomes for all sorts of reasons, also happen to have more access to green space.)
How exactly nature heals remains a matter of debate. Anthes speaks to two well-known psychologists at the University of Michigan, who tell her, as she paraphrases it, that “natural settings give the brain a break from the cognitively exhausting tasks—from memo writing to meal planning—that fill our daily lives. Nature draws our attention but engenders an effortless kind of engagement, often called soft fascination, that allows the mind to rest.”
American prisons are rarely designed to put people at ease. That’s why Anthes visits the Las Colinas Detention and Reentry Facility, a women’s prison in Santee, California, which incorporated new thinking about psychology and design into a facility upgrade in 2014. As one researcher tells her, “One of the things that the physical environment does, that humans respond to, is that it gives you a set of expectations about how people are likely to behave and how people think you’re going to behave—what we expect from you.”
The architects overseeing the redesign of the women’s prison decided, as Anthes put it, “that correctional facilities should look less like impersonal institutions and more like actual homes.” That meant replacing steel toilets, concrete benches, and metal tables bolted to the ground—built with the expectation of malicious damage—with wood furniture, much of it painted sea-foam green. Common areas included large windows and cityscape murals, rather than blank gray walls.
Most significantly, the guard station was situated at an open desk in a central dayroom, a design called “direct supervision.” “The more contact that staff had directly with the inmates, counterintuitively to some people, the safer everybody actually was,” one researcher told Anthes. “If the staff and the inmates were actually interacting, they started treating each other more like people instead of objects.” Assaults on staff dropped by half in the refurbished facility.
If there’s one thing I wanted more of from the book, it was a clearer view of which of these design tweaks might scale up from a quirky idea to broad reality. Will circadian lighting become mainstream for hospitals soon, and will open offices be relegated to the dustbin of history? Will more prisons reinforce the idea of rehabilitation over punishment in their designs? These questions don’t have purely scientific answers. Even good ideas need money and political backing. But that’s where books like this can help, especially if they find an audience among policymakers or entrepreneurs keen to imagine new spaces. It wouldn’t be the first time such ideas found resonance; mid-19th-century reformers in New York called for reimagining tenement housing, and their efforts brought about modern sanitation services.
Meanwhile, it’s a delight to daydream, especially as we hunker down in the middle of a pandemic. While we wait for the wider world to reopen, we might as well think about what will need to be reshaped, and what can be left behind for good.